Virginia Immunization Requirements: Doses, Exemptions, and Records

To enroll a child in a Virginia public or private school, daycare, or nursery, you must show proof of vaccination against diphtheria, tetanus, pertussis, polio, measles, mumps, rubella, hepatitis B, varicella (chickenpox), and, for younger children, Haemophilus influenzae type b. That is the short version of Virginia school immunization requirements, and the rules apply at admission, with only medical and religious exemptions recognized by the state.¹

The Required Vaccines and Doses

The Virginia Board of Health sets the schedule through 12VAC5-110-70. The current requirements for K-12 admission are:¹

Diphtheria: at least four doses, with one given on or after the fourth birthday before kindergarten.
Tetanus: at least four doses, on the same schedule as diphtheria.
Pertussis (whooping cough): at least four doses, with one on or after the fourth birthday, plus a booster before seventh grade.
Polio: at least four doses, with one on or after the fourth birthday before kindergarten.
Measles: two doses, first at 12 months or older and the second before kindergarten.
Mumps: two doses, first at 12 months or older and the second before kindergarten.
Rubella: at least one dose at 12 months or older.
Hepatitis B: at least three doses. Adolescents ages 11 through 15 may use a two-dose adult-formulation schedule.
Varicella (chickenpox): required for all children, with dose count depending on age.
Haemophilus influenzae type b (Hib): a complete series appropriate for the child’s age. Not required for children older than five or for K-12 admission.

The Board updates the list periodically based on recommendations from the CDC and the Advisory Committee on Immunization Practices.²

Extra Requirements Before Seventh Grade

Rising seventh graders need two additional shots on top of the K-12 baseline: the pertussis booster noted above and a meningococcal conjugate vaccine (MenACWY). The HPV vaccine is recommended for this age group but not required.² Schools enforce this at the start of seventh grade, so plan the appointments over the summer before.

Who Has to Comply

Every child entering a public or private school, childcare center, nursery school, family daycare home, or developmental center must show proof of vaccination before admission, including children transferring in from other districts or states.²

Homeschooling does not remove the obligation. Virginia Code § 22.1-271.4 requires home-instructed children to meet the same immunization standards “in the same manner and to the same extent as if the child has been enrolled in and is attending school.”³ The same exemptions are available, but choosing to homeschool is not itself a way to opt out.

How to Document the Shots

Vaccination records are submitted on the Commonwealth of Virginia School Entrance Health Form, known as the MCH 213G. The form requires the child’s name, date of birth, the complete date of each dose given, and a signature or stamp from a physician, registered nurse, or health department official.⁴ You can attach a separate signed immunization record in place of filling out the vaccine section directly, as long as the same information is included.

Providers can print the current MCH 213G from the Virginia Department of Health website.⁵ If you have lost your child’s records, ask the original provider’s office or your local health department for copies.

If Your Child Is Behind on Shots

A child who has started but not finished the required series can still enroll. Virginia allows conditional admission if the child has received at least one dose of the required vaccines and provides a written schedule showing when the remaining doses will be given. The standard completion window is 90 calendar days from enrollment, extended to 180 days when the child needs more than two doses of hepatitis B vaccine.⁶

Schools check back on conditionally admitted students. If your child falls off the schedule, the school will exclude the student until vaccinations resume. Put the 90-day date on your calendar the day you enroll, and book the follow-up appointments while you are still holding the initial paperwork.

One useful rule from the CDC’s catch-up schedule: a vaccine series never has to start over from scratch, no matter how long the gap between doses.⁷ Your pediatrician or local health department can plan the remaining doses within your conditional enrollment window.

Medical and Religious Exemptions

Virginia recognizes two exemptions for school enrollment: medical and religious. There is no philosophical or personal-belief exemption.

Medical Exemption

A licensed physician, advanced practice registered nurse, or local health department must provide written certification that one or more required vaccines would be harmful to the child’s health. The certification has to describe the specific medical condition and its expected duration.⁶ If the condition is temporary, the exemption expires when it resolves.

Religious Exemption

To claim a religious exemption, submit a notarized Certificate of Religious Exemption (Form CRE-1), available on the Virginia Department of Health’s immunization website. The form is an affidavit stating that immunization conflicts with the student’s religious beliefs or practices.⁸ Virginia does not require affiliation with any particular religious organization, and schools must accept a valid form without further inquiring into the family’s beliefs.

Because the CRE-1 must be notarized, plan a stop at a notary public. Virginia caps notary fees at $10 per act for paper documents and $25 for electronic notarizations.⁹ Many banks, shipping stores, and some public libraries offer notary services.

Exemptions Do Not Cover Outbreaks

An exemption on file does not guarantee uninterrupted attendance. When an outbreak or potential epidemic of a vaccine-preventable disease is identified at a school, the Commissioner of Health can order all unvaccinated students excluded from that school until the risk passes. The order reaches students with valid religious or medical exemptions, and the school has no discretion to override it.¹⁰ During a measles outbreak, for example, an unvaccinated student with a religious exemption could miss weeks of classes.

What Happens If You Do Not Comply

A Virginia school or daycare cannot admit a child who has neither an immunization record nor a valid exemption. If records are missing, the school must tell the parent that the child cannot attend and explain how to get vaccinated through a local health department or licensed provider.⁶ One exception: homeless children and youth, as defined in state law, may not be turned away for lack of records.

After admission, a conditionally enrolled student who misses catch-up deadlines will be excluded until vaccinations resume. The statute does not fine parents, but the lost school days can pile up quickly.

Paying for the Vaccines

Cost is rarely the obstacle. Federal law requires most private health insurance plans to cover all vaccines recommended by the Advisory Committee on Immunization Practices with no copay, deductible, or other cost-sharing, and every vaccine Virginia requires falls within that coverage.¹¹

Families without insurance, or with insurance that does not cover vaccines, can use the Virginia Vaccines for Children (VVFC) program, which provides federally purchased vaccines at no cost through enrolled public and private providers.¹² Children who are Medicaid-eligible, uninsured, underinsured, or American Indian or Alaska Native qualify. Your local health department can point you to a participating provider.

1
Virginia Code Commission. 12VAC5-110-70 – Immunization Requirements
2
Virginia Code Commission. Code of Virginia 32.1-46 – Immunization of Patients Against Certain Diseases
3
Virginia Code Commission. Code of Virginia 22.1-271.4 – Health Requirements for Home-Instructed, Exempted, and Excused Children
4
Virginia Department of Health. School Entrance Health Form MCH 213G
5
Virginia Department of Health. School Health Enrollment Forms and Action Plans
6
Virginia Code Commission. Code of Virginia 22.1-271.2 – Immunization Requirements
7
Centers for Disease Control and Prevention. Catch-up Immunization Schedule for Children and Adolescents
8
Virginia Code Commission. 12VAC5-110-80 – Exemptions from Immunization Requirements
9
Virginia Code Commission. Code of Virginia 47.1-19 – Fees
10
Virginia Code Commission. 12VAC5-110-120 – Exclusion of Students Unprotected Against Certain Diseases
11
Office of the Law Revision Counsel. 42 U.S. Code 300gg-13 – Coverage of Preventive Health Services
12
Virginia Department of Health. Virginia Vaccines for Children (VVFC)